Is age a determinant in cervical cancer screening in women aged 18 to 29?: An observational study

This study aims to analyze the impact of aging on cervical cancer screening among women aged 20 to 29. Specifically, it examines the occurrence of abnormal histological results and Cervical Intraepithelial Neoplasia (CIN) (+) lesions within these age groups. We retrospectively analyzed women aged 18 to 29 (<30) who underwent cervical cancer screening through cytology between 2014 and 2024. A total of 842 women who visited the gynecology outpatient clinic were included, and their Pap smear, colposcopy, and loop electrosurgical excision procedure/conization results were reviewed. Patients were divided into 2 age groups (18-25 and 26-29) for comparative analysis. Among the 842 women who underwent cytological evaluation: 744 (88.4%) had normal results, 51 (6.1%) were diagnosed with atypical squamous cells of undetermined significance (ASC-US), 31 (3.7%) with low-grade squamous intraepithelial lesion (LSIL), 8 (1.0%) with atypical squamous cells - cannot exclude high-grade lesion (ASC-H), 4 (0.5%) with High-Grade Squamous Intraepithelial Lesion (HSIL), and 4 (0.5%) with Atypical Glandular Cells (AGC). HPV (Human Papillomavirus) testing was performed on 75 women, and 40 (53.3%) tested positive for HPV. Colposcopy was conducted on 53 women, revealing CIN + lesions in 38 cases, while conization confirmed CIN + lesions in 23 cases. Colposcopy results revealed the presence of CIN 1, CIN 2, and CIN 3 lesions in both age groups. However, CIN 3 lesions were observed less frequently in the > 26 age group. Similarly, conization results showed a lower incidence of CIN 3 lesions in women older than 26. Women aged 18 to 25 had a higher likelihood of CIN 3 diagnosis. These findings emphasize the importance of considering age in the diagnosis of CIN (+) lesions during cervical cancer screening.